Pearls on the McRoberts maneuver

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February 2002 · Vol. 14, No. 2

Pearls on the McRoberts maneuver

Robert Gherman, MD

Dr. Gherman practices maternal-fetal medicine at Portsmouth Naval Hospital in Portsmouth, Va.

Key points

The McRoberts maneuver does not change the actual dimensions of the maternal pelvis. Rather, it relieves shoulder dystocia via marked cephalad rotation of the symphysis pubis and by flattening the sacrum.
The use of the McRoberts maneuver alone has been found to alleviate 39% to 42% of shoulder dystocias.
Prolonged application of the McRoberts maneuver may unduly stretch the fibro-cartilaginous articular surfaces of the symphysis pubis.

This procedure does not change the actual dimensions of the maternal pelvis.

A lthough shoulder dystocia occurs in less than 1% of all births, it can lead to serious injury of the infant and mother. Potential fetal complications include death, permanent neurologic impairment, brachial plexus injury, and Erb’s palsy, while the mother may suffer vaginal and cervical lacerations, significant blood loss, or uterine rupture.

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